Individual
MRS. KATTI LAINE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
14032 KENNINGTON PARK DR APT 306, RALEIGH, NC 27614-6994
(573) 318-6551
Mailing address
14032 KENNINGTON PARK DR APT 306, RALEIGH, NC 27614-6994
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
L005393
NC
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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